Perform 4 Purpose - Summer Camp Scholarship Application

Perform 4 Purpose Summer Camp Scholarship Application

Instructions:
Please complete the following application to the fullest extent. Your application will be viewed by the Perform 4 Purpose Summer Camp Committee shortly after the deadline. A decision will be made, and you will be notified following the meeting. We thank you for your support of Perform 4 Purpose, and we look forward to working with you. If you have any further questions or concerns, please contact programs@perform4purpose.org.

Confidentiality Notice: All information provided in this application is confidential, and will only be viewed by persons necessary to determine grant eligibility.

Do not fill in this field

Name of Student

Age of Student

Gender of Student

Address

City, State, Zip Code

Phone Number

School

City, State, Zip Code

Name of Parent/Guardian

Address (if different from Student's)

City, State, Zip Code

Phone Number

E-mail Address

Name of Recommender (if not parent/guardian)

Address

City, State, Zip Code

Relationship to Student

Phone Number

How did you hear about Perform 4 Purpose and the Summer Camp Scholarship?

What summer camp would you like the student to receive a scholarship for?

Perform 4 Purpose Summer Music Camp

Please describe why you think the student will benefit from the summer camp:

Please describe the student's financial situation to the best of your knowledge:

Will the student need to be provided with the proper instrument(s)/equipment for the camp?

Yes
No

Application Submitted By:

Date Application Submitted

You may also print a PDF of the application and submit it:

By mail:
Perform 4 Purpose, Inc.
8 Fourth Ave.
Auburn, NY 13021

By e-mail:
programs@perform4purpose.org